Provider Demographics
NPI:1477704807
Name:HARRINGTON, LISA MARIE (LICSW)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7625 METRO BLVD
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55439-3053
Mailing Address - Country:US
Mailing Address - Phone:952-945-4000
Mailing Address - Fax:952-945-4101
Practice Address - Street 1:7625 METRO BLVD
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55439-3053
Practice Address - Country:US
Practice Address - Phone:952-945-4000
Practice Address - Fax:952-945-4101
Is Sole Proprietor?:No
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN177221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical